Lung Ultrasound May Reduce Heart Failure Hospitalizations: Preliminary Results from the LUS-HF Trial

Abstract

Purpose Pulmonary congestion is expressed in the form of B-lines detected by lung ultrasound (LUS) which has proven to be a potent prognostic predictor of hospitalization and mortality in heart failure (HF). However, it is still unknown if a treatment strategy guided by LUS in HF patients may improve outcomes. Hypothesis LUS guided treatment in ambulatory patients after an admission for HF will reduce the combined end-point of readmission or unexpected visit for HF worsening or death in a 6-month follow-up. Methods LUS-HF (NCT02959372 at ClinicalTrials.gov) is a randomized, single center, simple blind clinical trial. Eligible patients are patients older than 18 years of age who have been hospitalized for HF (defined as shortness of breath , pulmonary congestion in chest X ray, NT-proBNP in the first 24 hours of admission: 450 ng/L, 50-75 years: >900 ng/L; >75 years: >1800 ng/L). The exclusion criteria are life expectancy of less than 6 months or severe lung disease . Eligible patients are randomized into either the “LUS group” or the “control group”. The follow-up consists of visits to the HF clinic at periods of 15 days, 1, 3 and 6 months after the initial hospitalization. Only in relation to the “LUS group”, the treating physician will have the result of the examination. The final estimated sample is 102 patients. Results We present the results of the first 52 patients included (26 in each group). Clinical characteristics are summed-up in the table. With a median follow-up of 180 days, 11 events were registered in the control group and 5 in the LUS group (42.3% vs 19.2%, log-rank test 0.077, figure). Conclusion According to the preliminary results of the LUS-HF trial, LUS guided treatment may reduce readmissions in HF patients.